Alcohol and Sex

I am a 29-year-old man who was diagnosed two years ago with type 1 diabetes. I had a pretty good sex life before the diagnosis, although I almost always had a couple of drinks before trying anything. They helped me relax.

Now, if I have a couple of drinks, I can’t perform. Drinking seems to just put me to sleep. But without it, I’m tense, which isn’t good either. Is this alcohol reaction part of diabetes? What can I do about it?

Frustrated Type 1

Dear FT1,

You have raised two important issues: alcohol’s effect on diabetes and alcohol’s effect on sex. The two effects are related. Let’s start with sex.

Alcohol’s Effect on Sex

You feel that a couple of drinks make you more relaxed about sex. We’re sure that’s true. Alcohol is well known for reducing inhibitions, making it easier to function in social situations. The inner voice warning you that “This is scary” is turned down. That’s why alcohol is often used by men and women to get ready for sex, and even for flirting or dating.

A couple of drinks may also make you feel more attractive and confident. This feeling obviously helps in approaching others or being in close contact. It may even make you more attractive to some potential partners. Confidence is a good thing.

Alcohol can also have the effect of making other people seem more attractive to you. This phenomenon (supported by science) is sometimes called “beer goggles,” defined by the Urban Dictionary as “a condition afflicting inebriated individuals, allowing mutual attraction between those who would ordinarily not be attracted.”

When people get much beyond two drinks, however, all these sex-enhancing effects become overwhelmed by the depressant and sedative effects of alcohol. You say that you “can’t perform” after drinking. We don’t like to think of sex as “performance,” but we understand your concern. After only two years of diabetes, with reasonably good control, this is probably not a problem of physical damage. It’s probably the booze. Erection problems with alcohol are so common they have their own name: “Brewer’s Droop.”

You may not have noticed such problems before, but you’re on insulin now, and that changes things. Here’s how diabetes gets into the alcohol/sex equation.

Alcohol’s Effect on Diabetes

The most common effect of alcohol on blood glucose is that it can make your sugars go low. According to December 2001 Nutrition Research Letter, “it has been estimated that as many as one-fifth of severe hypoglycemic episodes are directly related to alcohol.” Exactly how alcohol brings down sugars is unknown. One theory is that alcohol lowers cortisol levels. Cortisol is a stress hormone that keeps sugars up, so lowering it could cause glucose to drop, too.

Another theory concerns the liver. According to Amy Campbell, RD, author of Staying Healthy with Diabetes, “In most cases, your liver is able to release glucose when blood glucose levels start to drop, in an effort to prevent hypoglycemia. But with alcohol on board, this may not happen.” Campbell says the body treats alcohol as a poison, not a food. It sends alcohol to the liver as fast as it can, and the liver starts detoxifying it. Detoxification is a complex process that takes up most of the liver’s attention. So the liver may temporarily forget its other functions, like keeping your blood glucose up.You may not get the sweating, shaking, word-slurring kind of hypoglycemia when you drink, but even a small drop in glucose can affect erections and sexuality. In response to an earlier column about ED, several readers commented that their erection problems usually developed when their glucose levels went below about 90 mg/dL. When they got their levels up between 110 and 120, erectile function returned.

For people with type 2, alcohol can lower your glucose in another way, by stimulating insulin production. This may be a good thing after meals, but it’s probably not when you’re trying to be sexual. Of course, high blood sugars can interfere with sex, too. But alcoholic drinks usually don’t raise sugars much.

Sex Without Alcohol

FT1, our wish for you is that you learn to relax and feel confident without alcohol. That would be the best way to deal with your situation. You could talk with your doctor about a prescription or over-the-counter medication, but you probably don’t need drugs-and don’t forget that alcohol itself is a drug.

Try focusing on your breathing when you’re in a social situation or a sexual situation. Sex educator Annie Sprinkle says, “The single most important key to sex that I’ve yet discovered is conscious rhythmic breathing; the more you breathe, the more you feel and the more you come alive.”

In social situations, remember to take regular deep breaths (not so deep as to have everyone staring at you, just comfortably deep). Try breathing in through your nose, into your abdomen, and out through your mouth. Or practice the relaxed breathing exercises here. Even in bed, remember to breathe. Your partner and you will both enjoy the experience more if you are relaxed and breathing deeply.

There’s a kind of breathing meditation called Tantra, which is often associated with sex. You can see some tantric breathing exercises here.

The Bottom Line

The American Diabetes Association and other authorities say that moderate drinking is OK for people with diabetes. “Moderate” means two drinks a day for men and one for women. A drink is usually defined as about five ounces of wine, 1½ ounces of hard liquor, or 12 ounces of beer. Studies have shown definite health benefits associated with moderate drinking. With greater amounts, however, a lot of bad things can happen-from liver disease to auto accidents.

For sex with diabetes, though, many people will do best to avoid alcohol entirely. Try some breathing and relaxation exercises and see what happens.

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